The Fund previously supported a national study of large physician organizations to learn about their implementation and use of preventive services and care management processes for chronic illnesses. The findings showed that adoption rates for such tools and services as disease registries and patient reminders are low, but that external incentive programs and information technology are associated with higher use. The next step is to determine how medical groups that have implemented care management processes were able to do so. Researchers will visit 12 physician organizations, varying in type and level of performance, to determine the factors that help and hinder implementation. The dissemination of these findings will help providers improve the care they deliver to patients with chronic illness and help payers and policymakers create an environment that fosters quality improvement. The grantee will provide in-kind support for this project.